Percutaneous sperm retrieval in secondary azoospermia.
BACKGROUND
Males presenting for assisted reproduction after vasectomy have a high chance of normal spermatogenesis and of successful surgical sperm retrieval. We aimed to evaluate simple percutaneous methods of retrieving sperm for intracytoplasmic sperm injection in males with secondary azoospermia due to previous vasectomy.


METHODS
We analyzed a series of post-vasectomy males who presented for sperm retrieval between 1999 and 2005 and who were not being considered for vasal reconstruction as their primary method of re-establishing their fertility.


RESULTS
All 132 men had sperm retrieved successfully, 97% with percutaneous methods. In seventy-five percent of the couples intracytoplasmic sperm injection was done, with a total number of 184 cycles being performed. The clinical pregnancy and live birth rates were 25 and 24%, respectively. There were no significant scrotal haematomas, and only 2 patients had postoperative pain after percutaneous sperm retrieval that required analgesia for more than 2 days.


CONCLUSIONS
We have shown that percutaneous sperm retrieval, where normal spermatogenesis is assumed, is successful in all men following vasectomy. Percutaneous methods of retrieving epididymal or testicular sperm are inexpensive, simple and could replace open techniques in men who are not considering vasal reconstruction following vasectomy.
Bromage
S J
SJ
Department of Urology, Manchester Royal Infirmary, Manchester, UK. sjbromage@doctors.org.uk
Falconer
D A
DA
Lieberman
B A
BA
Shafar
B
B
Payne
S R
SR
D000328:Adult; D053713:Azoospermia / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D050498:Live Birth; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D018873:Pregnancy Rate; D020554:Sperm Injections, Intracytoplasmic; D053625:Sperm Retrieval / Q000009:adverse effects; D013091:Spermatogenesis; D016896:Treatment Outcome; D014659:Vasectomy